30% tests by private hospitals are irrelevant, say doctors at meet

At the conference ‘Healthcare: A Commodity or Basic Human Need’, doctors said a lot of the technology used in private corporate hospitals was not required to offer optimal care.Rupali Mukherjee | TNN | January 28, 2017, 09:40 IST

MUMBAI: Around 30% medical tests and hi-tech applications, including MRIs and ultrasounds conducted in a private healthcare set-up are completely irrelevant and cost a bundle, jacking up the patient’s medical bill by thousands of rupees. Stakeholders of private and public healthcare further underlined, at a Tata Memorial Hospital conference on Friday, that self-sustainability of medical institutions was the way forward and perhaps a more efficient model than public-private partnerships.

At the conference ‘Healthcare: A Commodity or Basic Human Need’, doctors said a lot of the technology used in private corporate hospitals was not required to offer optimal care. “In at least 15% cases, we cancel treatment or simply scale it down from what has been recommended. Often, over-investigation and over-diagnosis due to irrelevant tests, software and technological apps (applications) in a high-paying private hospital can be completely avoided as they add to costs, and still may come up with the same diagnosis,” said Dr Sunil Chandy, director, Christian Medical College, Vellore.

Speaking on the sidelines of the conference held by the Tata Memorial Centre on the occasion of its 75th anniversary, Chandy said if a doctor has conducted a thorough clinical examination and taken a good history of the patient, the tests and apps were often gimmicks. “The alarming rise in healthcare bills may be traced to these expensive tests, prescribed by doctors, even if they do nothing to help patients,” he said. In terms of not-so-efficient technology, Chandy cited the example of cardiac scans which could predict some heart problem but never pinpoint the exact cause till the patient has undergone an angiogram.

Tata Hospital director Dr Rajendra Badwe said merely 6% patients are subjected to MRI scans at the country’s premier cancer hospital in Parel. “But when a private hospital invests that much money in procuring a technology, it has to recover the money. The only way to do it is to prescribe scans to more people,” he said. Debating the need to evolve a successful healthcare model with accountability, affordability and accessibility, Dr Badwe said it should be self-sustainable.

The PPP models did not emerge as a favourite among experts. Chandy said the success of one greatly rests on the intent of both parties. “If the motive for a private player is profit, it will not succeed,” he said. Badwe said there are very few success stories to show.

Tata, CMC Vellore and Aravind Eye Care showcased at the conference their models that have developed affordable healthcare, wherein a significant percentage of patients are offered free medical care. Tata and CMC treat over 30% patients free of cost.

Tata Memorial Hospital, which receives an annual grant of Rs 170 crore from the Centre, may soon become self-sustainable. “It could happen over the next one-and-a-half years,” said director Dr Rajendra Badwe. The institute records 67,000 cancer cases annually. He added, “We have started generating that much revenue. Currently, we have a deficit of Rs 30 crore. We are working on measures such as adding a surcharge to medicines for patients in the affording class. While patients would still pay way less than the MRP, it can cover the deficit,” he said. “But the government should continue to pay for research and education,” he said, adding that institute earmarks more than Rs 100 crore for research.